The Day

3 grave risks of new GOP health care effort

If this bill passes, Republican­s will be held accountabl­e for a severe disruption to the health care system, resulting in less coverage for those who need it the most.

- JENNIFER RUBIN

The

Washington Post reports on the latest health care effort from Sens. Bill Cassidy, R-La., Lindsey Graham, R-S.C., Dean Heller, R-Nev., and Ron Johnson, R-Wis.: “The latest proposal would give states control over billions in federal health care spending, repeal the law’s key mandates and enact deep cuts to Medicaid, the federally funded insurance program for the poor, elderly and disabled. It would slash health care spending more deeply and would probably cover fewer people than the July bill, which failed because of concerns over those details.”

The bill leaves open the possibilit­y that states may radically cut back on the type of coverage offered and what has been a nearly iron-clad protection that those with pre-existing conditions cannot be denied coverage or priced out of the market.

In other words, one major risk for Republican­s is that this bill passes, and Republican­s are held accountabl­e for a severe disruption to the health care system that results in less coverage for those who need it the most.

Louisiana’s health department secretary, Rebekah Gee, already wrote a letter lambasting Cassidy, pointing out that 433,000 people in his state will lose Medicaid. She blasted him for his plan’s inclusion of per-capita caps on Medicaid that would cut services or the numbers who may be covered (or both). She calculated the bill would cost her state $3.2 billion through 2026, making it the eighth-biggest loser among states and “by far the poorest and sickest” state to get hit.

A second risk is that the Republican­s get themselves all ginned up again, only to find they lack the votes to pass the newest health care scheme. They will be ridiculed, em- barrassed and divided all over again. It would serve to remind Democrats that to prevent Republican­s from trying again and again to repeal Obamacare, they must turn out in 2018 to win back the majority in at least one house.

There is a third, more interestin­g risk. Sen. John Kennedy, R-La., posited that if Congress gives “a big chunk of money to California they’re going to go set up a single-payer system run by the state and then come back and say, ‘We don’t have enough money, we need more.’”

That is not altogether fanciful. Sen. Bernie Sanders, I-Vt., has rolled out his single-payer idea. If Obamacare is dismantled and money simply handed over to the states, every blue-state governor will come under pressure to try a single-payer system. The “laboratori­es of democracy” will be put to work test running the one healthcare system Republican­s dislike more than any other: single-payer. If a substantia­l number of states try this out, it may be virtually impossible for other states to resist. If, say, New York, New Jersey, California and some New England states all go to single-payer healthcare coverage, private insurers might not survive to offer coverage in other states.

Imagine the egg on the faces of conservati­ves if they manage to spur creation of single-payer health care in the United States. After all, Trump did promise he’d cover “everybody,” didn’t he?

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